scholarly journals Idiopathic Proximal Tibiofibular Joint Laxity in a Collegiate Baseball Player: A Case Report

Author(s):  
Stephen Cage ◽  
Brandon Warner ◽  
Diana Gallegos ◽  
Phil Stevenson

Objective: Present a clinical case detailing the assessment and management of a collegiate baseball player suffering from symptomatic laxity of the proximal tibiofibular joint. Background: Injuries to the proximal tibiofibular joint are rare, and generally accompanied by some form of trauma. Typically, dislocations of the proximal tibiofibular joint occur in an anterior direction, and require reduction and possible fixation as a first course of treatment. Treatment: A 20-year-old collegiate baseball player reported to the athletic training clinic complaining of idiopathic lateral right knee pain. The patient could not recall a mechanism, but recalled an insidious onset of pain that had begun two months prior to reporting to the athletic training staff. There has been some documentation of patients presenting with congenitally lax proximal tibiofibular ligaments, but at this time there is no demographic information on this patient population. Uniqueness: Most cases of proximal tibiofibular laxity occur as a result of trauma. In this patient’s case, there was no specific mechanism of injury or site morbidity to suggest an injury had occurred. Additionally, the patient was able to develop dynamic, and functional stability before regaining static stability. Conclusion: Anatomical abnormalities offer clinicians a unique opportunity to explore multiple levels of problem solving and patient assessment. Further research needs to be conducted to provide demographic data and treatment options for patients suffering from proximal tibiofibular joint laxity.

2018 ◽  
Vol 10 (7) ◽  
pp. 644-648 ◽  
Author(s):  
Leonardo Renieri ◽  
Eytan Raz ◽  
Giuseppe Lanzino ◽  
Timo Krings ◽  
Maksim Shapiro ◽  
...  

Background and purposeSpinal arterial aneurysms are a rare cause of spinal subarachnoid hemorrhage (SAH). We performed a retrospective review of spinal arterial aneurysms not associated with spinal arteriovenus shunts from three institutions in order to better understand the clinical and imaging characteristics of these lesions.Materials and methodsWe performed a retrospective review of spinal arterial aneurysms managed at three North American institutions. For each patient, the following information was collected: demographic data, clinical presentation, comorbidities, imaging findings, and neurological status at the last follow-up. Treatment strategies and outcomes were reported.Results11 patients were included; 7 were women and median age was 60 years. The most common presentation was sudden back pain (81.8%). We found 3 aneurysms on the radiculomedullary artery and 8 along the radiculopial arteries. Of the 3 aneurysms on the radiculomedullary artery, 1 was treated conservatively, 1 was treated with coiling of the aneurysm and sacrifice of the radiculomedullary artery, and 1 was treated with surgical trapping. The 8 aneurysms on the radiculopial artery were treated endovascularly in 4 cases, surgically in 1 case, and conservatively in 3 cases. One surgically treated patient had a spinal subdural hematoma. There were no other complications. Mean clinical follow-up time was 20 months, and 87.5% of patients were functionally independent.ConclusionsSpinal arterial aneurysms are lesions which commonly present with sudden back pain and spinal SAH. Conservative, surgical, and endovascular treatment options are safe and effective. Long term outcomes in these patients are generally good.


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